Augmentation cystoplasty: Urodynamic and metabolic outcomes at 10‐year follow‐up

Cheng, Kwun‐Chung; Kan, Chi‐Fai; Chu, Peggy Sau‐Kwan; Man, Chi‐Wai; Wong, Bill Tak-Hing; Ho, Ling Yin; Au, Wing-hang

doi:10.1111/iju.12943

Cited by 32 publications

(15 citation statements)

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“…Urinary tract stone formation is a common complication after AE because increased calcium excretion and the ineffective emptying of the augmented bladder leads to urinary stasis. The presence of urease producing bacteriuria and mucus production from bowel mucosa could certainly be other contributing factors . SCI patients who are wheel chair bounded are prone to have calcium stones due to immobilization.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of urease producing bacteriuria and mucus production from bowel mucosa could certainly be other contributing factors. 21 SCI patients who are wheel chair bounded are prone to have calcium stones due to immobilization. Therefore, annual physical check-ups and imaging studies are needed for the early detection of urinary stones in such patients.…”

Section: Discussionmentioning

confidence: 99%

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A real‐world experience with augmentation enterocystoplasty—High patient satisfaction with high complication rates

Kuo

2018

Neurourology and Urodynamics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A real‐world experience with augmentation enterocystoplasty—High patient satisfaction with high complication rates

Kuo

2018

Neurourology and Urodynamics

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“…Recurrent urinary tract infection can occur posttransplant in children with an augmentation cystoplasty. 21 It can also increase the risk of deterioration of renal graft function. Clean intermittent catheterization and antibiotic prophylaxis are important treatments to prevent urinary tract infection.…”

Section: Discussionmentioning

confidence: 99%

“…[21][22][23] Most patients who have augmentation cystoplasty require bicarbonate, resulting in a longer follow-up. 21 Chronic metabolic acidosis could lead to depletion of calcium carbonate from bone, which may cause growth retardation in children. 21 There is no significant increased risk of bladder cancer after bladder augmentation for a dysfunctional bladder.…”

Section: Discussionmentioning

confidence: 99%

“…21 Chronic metabolic acidosis could lead to depletion of calcium carbonate from bone, which may cause growth retardation in children. 21 There is no significant increased risk of bladder cancer after bladder augmentation for a dysfunctional bladder. 24 However, patients with spina bifida are at risk for cancer regardless of whether augmentation is performed.…”

Section: Discussionmentioning

confidence: 99%

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Aikawa

Muramatsu²,

Takahashi³

et al. 2018

Exp Clin Transplant

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Lower urinary tract abnormalities are difficult to resolve in pediatric kidney transplant patients. Measure of residual urine, voiding cystourethrography, retrograde urethrography, cystometry, electromyography of urethral external sphincter muscle, urethrometry, and uroflowmetry are the primary methods for evaluation of lower urinary tract abnormalities. Endoscopic resection or ablation of urethral valves is required in children with posterior urethral valve to treat obstruction, but bladder function does not always recover and may deteriorate to end-stage renal failure even after the obstruction is released. This bladder dysfunction in posterior urethral valve defines valve bladder syndrome. Vesicoureteral reflux caused by high vesical pressure can cause even worse renal graft function posttransplant. In our patient group, urinary diversion occurred with Mitrofanoff conduit using an appendix in 6 children, a Yang-Monti channel conduit using ileum in 1 patient, with cystostomy in 3 children, and with augmented cystoplasty in 9 children before or simultaneously with kidney transplant. These procedures should be selected based on the type of lower urinary tract abnormality including bladder function. Recently, we have preferred a continent diversion for self-catheterization in children with lower urinary tract abnormalities. We have conducted 9 augmented cystoplasty procedures using a portion of the sigmoid colon or ileum. Seventeen children retained their own bladders when the transplant ureter was implanted. Most patients needed clean intermittent catheterization, depending on the residual urine volume and a bladder function. Ten-year graft survival rate in kidney transplant in our department is 98% in 36 children with lower urinary tract abnormalities. Lower urinary tract abnormality is not always a risk factor for pediatric kidney transplant; however, a preoperative evaluation is important to choose the best option for urinary diversion. Key words: Bladder function, Preoperative evaluation, Urinary diversion IntroductionLower urinary tract abnormalities (LUTAs) can be divided into 2 groups: neurogenic bladders and lower urinary tract anomalies. A neurogenic bladder is caused by spina bifida, 1 anal atresia, 2 spiral cord injury or tumor, or cerebral palsy. Prune belly syndrome, 3 persistent cloaca, 4 and posterior or anterior urethral valve 5-7 all involve lower urinary tract anomalies.Pretransplant evaluations of LUTAs are important, particularly for children with neurogenic bladders and those unable to void through a native urethra. In this situation, a diversion or a conduit should be considered.The Mitrofanoff conduit using an appendix is preferred to a simple diversion for kidney transplant. 8,9 It is easy for a parent or a child to manage the clean intermittent catheterization (CIC) required with the Mitrofanoff conduit. The Mitrofanoff conduit is advantageous for children because it can be kept dry and a urine storage bag is not required.An augmentation cystoplasty for a neurogenic bladder with ...

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Intradetrusor botulinum toxin injections (300 units) for the treatment of poorly compliant bladders in patients with adult neurogenic lower urinary tract dysfunction

O'Connor

Johnson

Guralnick

2020

Neurourology and Urodynamics

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Aims: To evaluate the therapeutic effects of intradetrusor onabotulinum toxin A (BTX) injections in patients with adult neurogenic lower urinary tract dysfunction (ANLUTD) and medically refractory poorly compliant bladders. Methods: We retrospectively evaluated patients with urodynamic studies (UDS)-proven, medically refractory impaired bladder compliance (≤20 mL/cm H 2 O) secondary to spinal myelopathy treated with 300 units of BTX cystoscopically injected into the detrusor muscle. Objective improvement in compliance was defined as an increase ≥5 mL/cm H 2 O on repeat urodynamics. Characteristics were compared between patients who demonstrated symptomatic and objective improvement following treatment versus those without. Results: Seventy-one individuals were included in the final analysis. Mean patient age was 37.2 years (range: 18-78) and ANLUTD duration was 14.5 years (range: 1-34). Average pre-injection bladder compliance was 9.2 mL/cm H 2 O (range: 3.0-16.7). After treatment with BTX, 37 of 71 (52%) patients reported subjective reductions in lower urinary tract symptoms. Repeat UDS demonstrated objective bladder compliance improvements in 22 of 71 (31%). Individuals with shorter time intervals since neurologic injury responded better to BTX than those with longer durations (P = .032). Conclusion: BTX injections significantly improved symptoms and bladder compliance in 31% of ANLUTD patients with medical refractory poorly compliant bladders.

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Augmentation cystoplasty: Urodynamic and metabolic outcomes at 10‐year follow‐up

Cited by 32 publications

References 32 publications

A real‐world experience with augmentation enterocystoplasty—High patient satisfaction with high complication rates

A real‐world experience with augmentation enterocystoplasty—High patient satisfaction with high complication rates

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Intradetrusor botulinum toxin injections (300 units) for the treatment of poorly compliant bladders in patients with adult neurogenic lower urinary tract dysfunction

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